African trypanosomiasis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Pilar Almonacid

Natural History

1. A bite by the tsetse fly is often painful and can develop into a red sore, also called a chancre (SHAN-ker).
2. Symptoms begin within 1 to 4 weeks of getting an infected tsetse fly bite and begin with fever, headaches, and joint pains.
3. As the parasites enter through both the blood and lymph systems, lymph nodes often swell up to tremendous sizes.
4. Winterbottom's sign, the telltale swollen lymph glands along the back of the neck may appear.
5. If untreated, the disease slowly overcomes the defenses of the infected person, and symptoms spread to include anemia, endocrine, cardiac, and kidney diseases and disorders.
6. The disease then enters a neurological phase when the parasite passes through the blood-brain barrier.
7. The symptoms of the second phase give the disease its name; besides confusion and reduced coordination, the sleep cycle is disturbed with bouts of fatigue punctuated with manic periods progressing to daytime slumber and nighttime insomnia.
8. Without treatment, the disease is fatal, with progressive mental deterioration leading to coma and death. Damage caused in the neurological phase can be irreversible.

Prognosis

• No one is immune from East African trypanosomiasis. Even if you had the disease once, you can get re-infected.